Page 571 - Clinical Application of Mechanical Ventilation

Weaning from Mechanical Ventilation 537

2. The physician asks a therapist to evaluate the following ventilatory parameters for a possible weaning attempt.
The therapist should report to the physician that the only parameter that suggests successful weaning is:
A. spontaneous frequency (f) 5 40/min.
B. spontaneous V 5 7 mL/kg.
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C. minute ventilation 5 16 L.
D. PaCO 5 55 mm Hg.
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3. The oxygenation status of a 30-year-old postoperative patient shows: PaO 5 55 mm Hg, SaO 5 85%,
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Q /Q 5 25%, PaO /F O 5 118 mm Hg, F O 5 55%. Based on these data, the therapist should rec-
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ommend to the physician that weaning _______ begin because _______ of the measurements presented
above are within the recommended thresholds for a weaning attempt.
A. should, 50% C. should not, none
B. should, all D. should not, 50%
4. All of the following pulmonary measurements suggest readiness for weaning attempt except :
A. maximal inspiratory pressure 5 212 cm H O.
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B. V /V 5 40%.
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C. static compliance 5 32 mL/cm H O.
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D. f/V 5 80 breaths/min/L.
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5. A mechanically ventilated patient has the following oxygen content measurements: CcO 5 21.1 vol%,
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CaO 5 18.8 vol %, CvO 5 14.4 vol %. The calculated shunt is about _______ and it is interpreted
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as _______ shunt.
A. 17%, mild C. 34%, severe
B. 17%, significant D. 34%, significant

6. The PaO of a mechanically ventilated patient is 250 mm Hg on 100% oxygen. If the P O is 680 mm Hg,
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what is the alveolar-arterial oxygen tension gradient? What is the estimated shunt if every 50 mm Hg difference
approximates 2% shunt?
A. 430 mm Hg, 8% C. 940 mm Hg, 17%
B. 430 mm Hg, 17% D. 940 mm Hg, 34%

7. Ms. Warren, a mechanically ventilated patient recovering from drug overdose, has a PaO of 76 mm Hg
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on 30% oxygen. What is the PaO /F O (P/F) index? Is the P/F index normal based on the oxygenation
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criteria for weaning?
A. 25.3, normal C. 253, normal
B. 25.3, abnormal D. 253, abnormal

8. A patient has the following measurements while receiving mechanical ventilation: corrected tidal volume 5
480 mL, peak inspiratory pressure 5 45 cm H O, plateau pressure 5 30 cm H O, PEEP 5 8 cm H O. What
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is the calculated static compliance? Is it normal based on the pulmonary measurement criteria for weaning?
A. 11 mL/cm H O, normal C. 22 mL/cm H O, normal
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B. 11 mL/cm H O, abnormal D. 22 mL/cm H O, abnormal
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